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Plastic and Reconstructive Surgery

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Patient Forms and Brochures

You should fill out the Patient Intake Form before you come in. Your surgeon can advise you if there are more forms you need to fill during or after your first appointment.

For all patients:

  • Records Request Form This is the form that gives your surgeon permission to get your medical records.

For breast augmentation patients:

  • Saline-Filled Breast Implant Surgery Brochure The purpose of this brochure is to assist you in making an informed decision about breast augmentation and breast reconstruction surgery. This educational brochure is set up to help you talk with your surgeon, as well as provide you with general information on breast implant surgery and give you specific details about breast implants.
  • Silicone Gel-Filled Breast Implants Brochure The purpose of this brochure is to help you in making an informed decision about having breast implants for augmentation (breast enlargement) or breast revision-augmentation (replacement) surgery. This brochure provides you with information about risks and benefits of silicone gel-filled breast implants.

For cleft lip and palate patients:

Para pacientes con labio leporino y paladar hendido: